Introduction
Brief Overview of Adolescent Mental Health Challenges
Adolescence certainly has a special place as a developmental time of life, which is defined by the numerous physical, emotional, and social changes. These happenings coupled with possible exposure to contaminants such as violence, poverty, alcohol and drug abuse as well as on the street violence can make adolescents vulnerable to psychological problems [1]. Dealing with mental disorders, half of which are not notified, is common in the 10-19 year age group across the world. These unreported cases make one in seven 10-19-year-olds suffer mental disorders, which account for 13% of the global burden of disease throughout the age group [1]. The high prevalence of diseases such as depression, anxiety, and behavioral disorders among teens (age]) constitutes the main reason for the prevalence of morbidity and disability in adolescents (age]. The aftermath of leaving youth mental health problems unchecked may hurt an individual into future time, putting a strain on physical and mental health status as well as respectively ruining their chances to lead pleasant lives as adults [1].
Introduction to Attachment-Based Family Therapy (ABFT)
Attachment-Based Family Therapy (ABFT) is a type of family therapy which will be done by a mental health professional. Main purpose of this therapy is to either repair rifts in the relationship between parents and children or establish a situation where they rebuild an emotionally close relationship [2]. The intervention is derived from an attachment based approach and has been found through research to be well-grounded and yield positive outcomes for teenagers experiencing suicidal ideations or depressions [2]. As the salient feature of ABFT, as mentioned, is to fortify the distress bonding between a parent and a child to serve as a cradle that helps as a pre-emptive measure against depression and suicidal behavior [2].
Importance of Family Relationships in Adolescent Development
Cuddling up with your parents, siblings, and relatives can be a great boost to your self-worth, wellbeing, and the general feeling of safety [3]. These experiences are a relating stepping stone that eases the challenges common among teenagers. Even though friends might be the dominant group in the young people’s life now, the family stays the key in the teenage’s life[4]. As we step into 2020, 79 percent of participants (aged 15–19) rated their family relationships to be either as extremely important (43 percent) or very important (36 percent) in the same study[4]. In spite of the fact that the strong family cohesion is connected with the high capability to deal with hard senses, resilience is even better not to be limited to one field [3].
Understanding Attachment Theory
Overview of Attachment Theory
Attachment denotes a bond between two individuals which is a concept advanced by John Bowlby who is from Britain. It advances the idea of a physical entity with a biological urge to treasure meaningful ones [5,6]. As per attachment theory, a child develops a secure attachment when parents are sensitive to meet the needs of their children and are consistently available (Chaleye, 2021; Diana, 2012). Being securely attached with parents or caregivers is probably to help the child’s emotional development where children who feel secure attachment are more likely to have a good emotion regulation and a positive self-esteem and identity [5,6].
Key Concepts: Secure Attachment, Insecure Attachment, and Attachment Styles
When the bonds and emotions, such as abandonment, neglect, criticism, and detachment are born and kept alive in relationships, the confidence in the relationship is hit hard and insecure attachment may be one of the choices [7]. Attachment theory, thus explains that when children are upset or under stressful conditions, they are genetically disposed to seek an encouraging and comforting environment from their parents [8]. If children encounter their parents as interested and present with them in distress, they can be certain the place is a safe one and they are also worthy of love and protection [8].
Relevance of Attachment Theory to Family Therapy
Attachment theory is especially valuable in exploring not only the route to development of negative coping behaviors but the obvious mechanical background of personal emotional problems as well [9]. Change is central to it and, thereby, it plays a significant role in family therapy. The family must have a strong enough attachment to a therapist so that they can feel safe and comfortable to search for variations in their relationship [10]. By exploring the emotional bond between siblings as an opportunity for support, growth, and connection, attachment-based family therapy (ABFT) aims to facilitate the development of skills for resolving conflicts and regulating emotions.
Overview of Attachment-Based Family Therapy (ABFT)
Origins and Development of ABFT
ABFT (Attachment-Based Family Therapy) is basically grounded on John Bowlby’s attachment theory [7,11], in which a safe, enduring and reciprocal bond leads to lowered stress levels and increased physical and psychological well-being. The precise treatment manual was developed by Guy Diamond, Gary Diamond, and Suzzane Levy in the book Attachment-Based Family Therapy for Adolescents with the Seasonal Depression [7]. Depression and suicide in adolescence are addressed through a family-based treatment model which is manualized EBP for treating family relationships as well as preventing a disorder [7].
Core Principles and Techniques
ABFT is a compass-directed, process-based, and centers around the emotions [7]. This model is amalgamation of other family therapy models namely multidimensional family therapy, emotion-focused therapy and structurally determined Minuchin’s family therapy [7]. ABFT has an established sequence of five treatment tasks that are carefully scanned and completed as the therapy unfolds [7]. To begin with we do the relational reframe which, generally, is taken for one session. The transactional approach introduces relational reframe where the friendship concerns are repositioned and the relationship between the parents and a child who is distressed is then considered [7].
Goals of ABFT
The goal of ABFT includes children proactively trying to bring friendship to their parents, learning how to solve their problems, and communication between parents and children, respectively in order to build their trust, self-esteem in parenting and protect child’s positive expression of needs [12].
The Role of ABFT in Healing Family Relationships
Addressing Conflict and Communication Issues within the Family
Attachment-Based Family Therapy (ABFT) is one of the kinds of family therapies which aim at mending relationship rifts and helping to develop and / or rebuild an emotionally secure relationship [13]. It is meant to develop security connection between a parent and child and to ground a relationship that can serve as the strong basis for the child to withstand and avoid depression and suicide [13].
ABFT helps families dealing with troubled situations to resolve conflicts through practicing several methods. One of the critical steps is conflict resolution, this means that the counselor should see the family together and tackle the problem as a team [14]. Another step is the development of problem-solving skills[15]. In addition to communication as one of the main topics, it deals with easing communication between the children and their parents [16].
Rebuilding Trust and Emotional Bonds between Adolescents and their Caregivers
In terms of the therapy-administered process, attachment-based family therapy identifies the problematic areas of trust, seeks for the strategies of a supportive caregiver-child relationship and, as a result of using attachment therapy techniques, aims to relieve a child of trauma stored inside or in their memory [17]. Trauma based therapy, which may also be an attachment-based treatment, appears to be what adults like this require to address attachment style concerns [17].
The talk therapy helps family members comprehend and verbalize their emotions, which result in an environment free of fear and protection [18]. It also means generating love and intimacy, learning and finding new skills in solving conflicts among children and parents, and boosting confidence on the part of children, building a secure future for them [15].
Creating a Secure Base for Adolescent Development
The Secure Base model provides a favorable context for caregivers to facilitate emotional development, which is the first step that helps infants, children, and young people find a new app [19]. Rather than doing macro examinations of the professional caregiving field, it narrows down the scope to the specific interactions that those within the profession oversee on a day-to-day and minute-by-minute basis [19].
A place of safety serves as a starting point to reduce one’s fear, and then supports the youth in being able to freely take action, to be in the thought, to frolic and learn, and to bring out what’s within him or her [20]. Key to promoting security and resilience is mind-mindedness: The caregiver could be trying to see things from the perspective of the young person or perceive what they (the young person) might wish [20].
Case Studies and Success Stories
Real-life Examples of Adolescents who have Benefited from ABFT
Whether in the classroom or the workplace, ABFT has become a useful tool. Likewise, LGB-respective adaptations and pilot-testing for depressed and suicidal LGB adolescents were conducted [21]. The sessions allowed these young adolescents to enjoy an increment which they had never dreamed of before [21].
Another research comprised ss colleagues from 60 adolescents suffering from major depressive disorder (MDD) that were randomized trial into two groups, which were ABFT and the treatment as usual (TAU). The research revealed that in both ABFT and TAU conditions there was a significant decrease in the symptoms of depression [22].
Testimonials from Therapists and Families
Multiple ABFT willingly confess that they have thrued positive future experience. Likewise, one was recounting a story of attending the session as a family and felt it was an open platform for such disclosures in terms of how one’s childhood affected them. In fact, spending time with the counselor made them realise that even those families that have drama from the past aren’t condemned to be a group of dysfunctional people [23].
It turned out that for the last 2 years, an individual has been cooperating with their therapist and has learned by now the importance, insight, compassion and the true professionalism traits of a therapist while working with them [24].
To sum it up, ABFT provides a platform that allows for the addressing of conflicts and communication problems, reviving of trust and rebuilding of prior bonds, and building an atmosphere of safety that helps with adolescent development. The testimonials from therapists and families living in the community which have benefited from these services have created a platform where first-hand evidence concerning this effectiveness has been documented.
Challenges and Considerations
Limitations and challenges of ABFT
Criminality presents challenges to families. Attachment-Based Family Therapy (ABFT) is a proven-practice broadly adopted by all professionals in the field [25]. Finally, the fact that it is one of the types of therapy like others suggests that it also poses some limitations. For example, instead of being better than the TAU, a research discovered that ABFT was not more effective than the Treatment as Usual (TAU) for treating Major Depressive Disorder (MDD) in adolescents [26]. While the remissions and the response rates were low in both groups, however, it indicated no treatment were effective in managing MDD in adolescents [26]. The available evidence should be taken into account by keeping the limitations in mind, such as the small size of the study group, missing data and the problems with the implementation [26].
Cultural considerations in applying ABFT
Cultural characteristics make a great difference while doing CBT. The following paragraph specifies the practical points in building cultural competence [27] The central proposition is that everyone has a culture that is impacted by the culture and sub-culture to which they belong and that their lives are an interplay of their own life experiences and the general culture [28]. As therapists are expected to flexibly apply culturally adapted interventions and be aware of their own biases and propensity toward stereotyping, should the multi-ethnic site of therapy be considered [28].
Ethical considerations in family therapy
A variety of ethical issues related to family therapy are among them that competence and multicultural awareness play a significant role, in addition to informed consent, boundaries and multiple relationships, and legal issues related to confidentiality and its exceptions, the duty to warn, and child custody issues [29]. The state laws dictate and visitors to the state can be subject to an investigation to malpractice through the state professional boards [29].
Future Directions and Research
Current research findings on the effectiveness of ABFT
Realistically, ABFT for adolescents and the families facing depression or suicide have been researched thorough a psychotherapy [30]. Notwithstanding, a research demonstrated that the ABFT was no more proficient in curing teenagers with MDD from depressive problems than TAU [26]. Both the control group members and adolescents in the treatment were significantly benefited however still a lot of them were in the clinical depression range even after the 16 weeks of treatment [26].
Potential advancements and adaptations of ABFT
ABFT has been modified to differentiate the target population and the presenting issues (Hen et al., 2021). For one, for anxiety disorder, a study suggested that ABFT program before CBT program can assist having better outcomes [32]. The case with ABFT is that it is sensitive and leaves spaces for family and community social factors. As a result, minority group children and those who live in societies which do not value individualism might find the model more relevant and auspicious in solving the factors of their anxiety [32].
Areas for future research and exploration
Future research should focus on the moderators of a and the mechanisms through which people respond to treatment, as well as the feasibility and cost-effectiveness of reconstructing sessions and in non-research settings that might necessitate years of extensive training and expertise [26]. The next line could focus on other issues that were not covered such as the elaboration of some mechanisms of change [33]. This will determine how improved connection and relationship with mother and family function as mediators of treatment success. [33].
Conclusion
Recap of the Significance of ABFT in Adolescent Mental Health
The attachment-based family therapy program (ABFT) is a structure of mental health actively serving teenagers and young adults who struggle with depression [34]. It is the only evidence based integrative family therapy model that directly targets family and individual processes linked to adolescent depression, among other psychological and mental disorders [35,36]. ABFT aims for repairing the parent-child relationships that have been damaged and contributing to the child’s emotional support [37,38].
MDD, the Major Depressive Disorder is one of the illnesses that prevail among teenagers with a huge extend of influence on their quality of life as of the official medical statistics [37]. Being the only family therapy model developed on the basis of empirical data to date and designed to eliminate interpersonal disruption and facilitate building up the emotionally safe parent-child relationship, ABFT utilizes principles of attachment theory [37].
It should be emphasized that while the ABFT was not better than TAU according to some of the studies [37,39], it demonstrated a positive impact in other researches. It shows that there could be an inadequate level of has been done to completely understand how Abbreviated Behavioral Footprints will be useful with adolescents [37].
Encouragement for Families and Therapists to Explore ABFT as a Treatment Option
Regrettably, ABFT results are ambiguous; nevertheless, this form of treatment has to be considered as a worthy choice. Rather military manuals for families of adolescents and their loved ones, it was developed to cure, eliminate painful thoughts about self-harm and anxiety disorders [40].
Moreover, ABFT is dominated by emotional and process-oriented modality, it can be termed as a semi-structured treatment program [37]. The model aims to both better the individual functioning of adolescents as well as that of their parents and improve interpersonal processes between them which are supposed to help to build up the context where individual development can take place [37].
For psychotherapists and families, ABFT may be used as a proper therapy, mainly due to its specific emphasis on repairing rifts in attachment or connection, followed by the approval of early intimacy [38].
Final Thoughts on the Importance of Nurturing Secure Family Bonds for Adolescent Well-being
Physical family relationships serve as a source of strength, support, and resilience for teenagers. Strong emotional connections to people around and nurture inner strength, trust and self-esteem are among the essential benefits of such bonds [41]. They can all use this chance to start leaving the family and make friends who respect them. Causally, emotionally stable peer associations lessen the risk of a adolescent experiencing emotional disturbances or antisocial behaviors [41].
Bonding with the family force serve as a vested buffer against stress, ignite happiness and create feelings of security in the inner self and help us to feel that we have found our place in life [42]. It’s in those moment of intimate and open talks when we learn to understand and direct our feelings, cope with conflicts and cope with challenges [42]. However, being skillful in this regard, means more to you than just being mentally healthy [42].
The parent-teen relationship, which assists in the facility of the developmental and wellness of teenagers, propels teenagers through their stages of their life [43]. An effective bond, in turn, helps to raises the level of emotional intelligence, builds self-esteem and resilience in teenagers through which they become capable of dealing with life’s obstacles [43].
Briefly, apart from the fact that a secure family connection is only beneficial, but also compulsory for a healthy teen’s life. It should be the aim, irrespective of the method they choose, to establish the bonds and thereafter make it a conducive and loving environment in which they can nurture the youth.
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